DESCRIPTION: (Adapted from the applicant's abstract and Specific Aims.) Investigation into the surfactant system of the mature lung has increased substantially. Laboratory and clinical scientists have demonstrated abnormalities of the surfactant system coincident with the adult respiratory distress syndrome (ARDS), tobacco exposure, and various other conditions of the mature lung. Interest has been spurred by demonstrations that administration of exogenous surfactant to animals with acute lung injury improves gas exchange and outcome. Consistent with these observations, pilot studies suggest that gas exchange and outcome are also improved in patients with ARDS who receive exogenous surfactant. Whereas severe limitations in supply have previously hampered the ability to perform clinical studies, the development of synthetic surfactants with excellent biologic potency now permits those studies. A gap in knowledge exists between scientists, both in the clinic and in the laboratory, whose studies have been stimulated by pathology of the neonate and scientists interested in the pathology of the mature lung. Understanding of surfactant biosynthesis, metabolism, structure/function relationships, and clinical application has matured during the past two decades, but has focused largely on problems associated with neonatal medicine. The application proposes to provide a forum to present the current state of knowledge to investigators concerned with pathology of the mature lung and to enhance communication between those investigators and leaders in surfactant research. The proposed meeting would occur in San Diego, CA on March 23-25, 1995, and would include 14 hours of scientific presentation and discussion. Attendance by 125 individuals is anticipated and approximately 30 speakers would be invited to present relevant topics.